Presentation:
A 9 year old spayed female poodle was presented to AcaseAweek Clinic with a one month history of bloody urine which has progressively gotten worse in the past 2 weeks. The owner claims to have seen blood clots passed in the urine recently. The patient has not been eating well for the past 2 days and has vomited 4 times in the past 24 hours. Animal is unvaccinated and has no history of flea or heartworm prevention. Dog is fed home-made food.
Physical exam:
- Weight: 7.04 kg
- Temperature: 105.2 F
- Pulse: 112 bpm
- RR: 54
- MM: pale
- CRT: 2 sec
Complete Blood Count:
- Hct: 27% (37-55)
- RBC: 5.2 x109/L (5.5-8.5)
- Hb: 10.3 g/dL (12-18)
- WBC: 3.2 x 109/L (6-16.9)
- Grans: 1.7 x 109/L (3.3-12)
- PLT: 374 x 109/L (175-500)
- TP: 9 g/dL (5.2-8.2)
- nRBC : 1%
Biochemistry Profile:
- AP: 65 U/L (23-212)
- ALT: 35 U/L (10-100)
- Glob: 4.9 g/dL (2.5-4.5)
- Alb: 2.6g/dL (2.7-3.7)
- BUN 33 mg/dL (7-27)
- CREA 1.3 mg/dL (0.5-1.8)
Urinalysis:
- Colour: Red
- Odour: Strong
- Turbidity: 3+
- G: 1.019
- pH: 8.5
- Glucose: -ve
- Bilirubin: -ve
- Ketones: -ve
- Protein: 4+
- Blood: 3+
- RBC: 3+
- WBC: 3+
- Squamous: few
- Transitional epi: -ve
- Tubular epi: -ve
- Bacteria: 3+
- Casts: -ve
- Crystals: 2+ (struvite)
Abdominal radiographs were taken as shown below (click on the image to enlarge):
 What are radiographic findings? What is your diagnosis? What further diagnostic tests will you perform? How will you treat and manage this case? Solution to this case will be posted on 2/13/09. |
